by Matt Burgess
SYDNEY, July 1 (Xinhua) -- Despite significant reductions of Tuberculosis (TB) cases in the Western Pacific, more needs to be done to grapple the deadly disease that risks spreading with global population movements.
Tuberculosis, one of the world's worst bacteria pathogens affecting the lungs, accounting for 1.3 million deaths worldwide annually, has been ravaging the Western Pacific.
Despite significant achievements in reducing the disease's prevalence - by up to 50 percent in some Pacific countries - it still claims more than 100,000 deaths each year in the region's poor and vulnerable communities.
Papua New Guinea (PNG) has deemed its most recent outbreak on the small island of Daru and in the capital city Port Moresby as a "national emergency", with almost 30,000 new infections each year, mostly from multi-drug resistant TB strains.
"For years, the health sector has been underfunded, which means that TB services could not reach populations that were without access (due to geographical difficulty), and the program has also had funding difficulties over the years," World Health Organisation (WHO) country representative to PNG, Pieter van Maaren told Xinhua on Friday.
"That doesn't mean no progress has been achieved. At the moment, a good national TB control program is in place."
PROGRESS BEING MADE
The WHO is currently aiming to end the global TB epidemic by 2035 through five-year national control plans to focus on the most cost-effective, high-impact treatment and pre-emptive measures.
In PNG, USAid has partnered with U.S. drug company Janssen Therapeutics to provide Bedaquiline, the world's first anti-TB drug in 40 years, and a rapid diagnostic machines for PNG's control plan to help combat the current drug-resistant TB outbreak.
"It's a significant advantage," van Maaren said, noting the GeneXpert machine reduces pathology time to a matter of hours, rather than weeks to confirm diagnosis.
"The earlier you can get patients on treatment, the faster you interrupt the transmission of the disease. You cut down the time that people are infecting others."
Global research into combating TB are beginning to bare fruit after U.S. researchers modelled the formulation of Tuberculosis granulomas - the non-active form of infection found in over two billion people worldwide - in host's the lung. The granulomas develop as the host's immune system attacks the TB bacteria, but are unable to remove it.
By modelling the granulomas and understanding their complex life-cycles, researchers may be able to identify new antibiotics, antibiotic targets, and biomarkers that can predict the transition from being inactive to a potentially deadly infection.
"Discovering the factors involved in granuloma control versus those not able to control bacterial growth is a critical step in potentially developing treatments that could 'freeze' granulomas into a protective state in the two billion latent carriers," U.S. National Institute of Biomedical Imaging and Bioengineering (NIBIB) program director Dr Grace Peng said in a statement.
"Computer modelling, also known as in silico modelling, of such a complex disease allows us to work toward potential treatments much more rapidly."
GLOBAL CONNECTIVITY WORRIES
Transmission however have authorities worried, as a large proportion of PNG's multi-drug resistant cases are identified from Daru Hospital in PNG's southwest, a key stepping point for the peoples of the Australia's Torres Strait. At its closest point, PNG is just four kilometers from the Australian territory of Saibai Island in the strait.
"It's not just a matter of worrying for Australia, I think everyone should be concerned when there is an outbreak of drug resistant TB," van Maaren said.
"Yes people move across borders, but people move to the Philippines, people move to New Zealand (as well)."
"Once people cross borders, there is always a chance that a disease gets transmitted as we've seen with Ebola, we've seen it with SARS, we've seen it with the Zika virus. "
"With the current way of people's movement across the globe, you cannot prevent transmission or limit transmission to just one country."
Multi-drug resistant TB is less susceptible to even the most effective known TB medication, proving eradication of the disease will be highly problematic.
"The TB disease, once a significant proportion of the population is infected, it will take many decades before you really see a situation where you get close to elimination," van Maaren said.
The WHO is currently undertaking a cost analysis examining how much money will be needed over the next five years to combat TB in PNG alone, but it's anticipated to be in the millions of dollars.
"Australia and now the U.S. and also several international NGOs are already providing support in assisting the (PNG) government with its TB program," van Maaren said.
